Related concepts: Acute otitis media, otitis media, AOM Introduction to ear infection: Many parents are familiar with being awoken by a crying baby with an ear infection. Ear infections are the most common reason that children take an extra trip to the doctor, take antibiotics, or even have surgery. What is an ear infection? Ear infections come in several varieties. Most people use the phrase “ear infection” to refer to otitis media, an inflamm…

Dr. Greene’s Answer: The current measles-mumps-rubella vaccine (MMR) does not contain a significant amount of egg proteins (but two other vaccines do). As recently as 1994, the AAP recommended skin testing of all children with severe egg allergies before they received the MMR. This is no longer necessary. Even those with dramatic egg allergies are extremely unlikely to have an anaphylactic reaction to the MMR. The benefits of the vaccine f…

When the measles vaccine was first introduced, the number of measles cases plummeted. But a few years ago, new outbreaks prompted a reevaluation of the vaccine. In some people the immunity had faded after only one dose of the vaccine, so the schedule was changed to include a booster dose. In 1999 there were only 100 cases of measles in the United States, 71 of them brought in from another country. And now it’s official — as of Augu…

Rotaviruses are the leading cause of both routine vomiting and diarrheal illnesses and of severe, life-threatening diarrhea in every country in the world. Click here to read more about rotaviruses. About 50,000 children are hospitalized in the United States each year for rotavirus infections (JAMA 1998;279:1371-6). Rotaviruses cause about 1 in 78 children in the United States to be hospitalized before they enter kindergarten. They are the lead…

When your child first packs up and heads off for college, it is a bittersweet moment. How horrible if meningitis were to make the separation permanent. College students get meningitis 2.6 times more often than peers the same age (American Journal of Public Health. 1995;85:843-845). Beginning in 1997, the American College Health Association (ACHA) recommended considering meningococcal vaccination for all college students. Many students are not…

The flu epidemic appears to be winding down in the United States, having killed 93 children between October 2003 and January 6, 2004. About a third of these kids had another underlying medical condition. The median age of the 93 children was 4 years, according to the January 9, 2004 MMWR. This year’s flu gives immediacy to recent recommendations to give children with chronic medical conditions and all children age 6 to 23 months the flu v…

One evening a child has a high fever, a severe headache, and a stiff neck. It might be just the flu — or it might be meningococcal meningitis. This devastating disease, though still uncommon, has been striking more often throughout the last decade. The child might be dead within hours. Those that survive meningococcal meningitis are often left with neurologic disabilities, hearing loss, and/or loss of a limb. Those between the ages of 15…

The newly approved Lyme disease vaccine is not yet proven safe and effective for children under age 15, although the vaccine looks promising for children in studies currently underway. In the meantime the American Academy of Pediatrics has issued January 2000 guidelines for the prevention of Lyme disease. Because a tick needs to be attached for at least 36 to 48 hours before it can transmit Lyme disease, the most important measure is checking…

Related concepts: Hemoglobin S Introduction to sickle cell anemia: Normal red blood cells are soft, gel-like discs that can squish as needed to slip through the tiny capillaries of the body. In sickle cell disease, the red blood cells are brittle. What is sickle cell anemia? Sickle cell disease is caused by a genetic variation of hemoglobin, the molecule that carries oxygen in the red blood cell. Sickle hemoglobin (hemoglobin S) is very slightl…

Multidrug-resistant strains of pneumococci are common in the US and continue to increase — especially in children under age 5 — according to a report published in the December 28th, 2001 issue of the New England Journal of Medicine. The authors are hopeful, as am I, that the pneumococcal vaccine, Prevnar, will protect children from these strains of bacteria. Whether or not a child receives this vaccine, it is wise to avoid creating…

Most bacteria and viruses that cause infections in humans thrive best at 98.6 degrees F (37C). Raising the temperature a few degrees can give the body the winning edge. In addition, a fever activates the body’s immune system, accelerating the production of white blood cells, antibodies, and many other infection-fighting agents. Brain damage from a fever will not occur unless the fever is over 107.6 degrees F (42C) for an extended period o…

Hundreds of thousands of health workers and volunteers are mobilizing to reach every child in 5 countries with polio vaccine within just a few days – in countries where polio had previously been eradicated. 15 million children are considered at immediate risk. The World Health Organization called the spreading polio outbreak in Nigeria “a grave public health threat” in their October 22, 2003 alert. The polio virus is quite contagious. It sprea…

Related concepts: Acute bacterial sinusitis, Chronic bacterial sinusitis, Subacute bacterial sinusitis Introduction to sinusitis: That runny nose and cough just won’t go away… Perhaps your child has a sinus infection. Sinusitis is a common problem in children. Nevertheless, it is often over-diagnosed in children with green runny noses, and missed in children who really have a sinus infection! What is sinusitis? The sinuses are small empty caver…

Guidelines have been set for many health issues. Experts are able to devote a considerable amount of time to a particular question (far more than an individual physician could ever hope to achieve), thus the benefit of many experts’ in-depth knowledge on many different questions is now available to individual families and physicians. A subcommittee of the American Academy of Pediatrics and the American Academy of Family Physicians, called…

Type 1 diabetes has increased in children over the last decade, presumably triggered by something in their diet or in their environment. Some have suggested that perhaps the disease is triggered by a child’s response to vaccines. The April 1, 2004 New England Journal of Medicine contains the results of a huge investigation into this question. Danish investigators analyzed the medical records of all children born in Denmark born between mi…

In 1999, the Centers for Disease Control and Prevention (CDC) recommended routine Hepatitis A vaccination for children in high-risk areas. Hepatitis A is a serious, debilitating disease that can be spread easily by mouth. Children often get it from eating foods that are contaminated when infected farm workers or food handlers fail to wash their hands sufficiently or observe proper hygiene. Once infected, children readily spread it among themsel…

Related concepts: Laryngotracheobronchitis, Infectious croup, Spasmodic croup. Introduction to croup: Picture this scene: A couple is spending a quiet evening at home with their one-year-old daughter, who has had a bit of a cold. At about 8 o’clock she begins coughing — an unusually loud, resonant cough. Over the next few hours, the sporadic cough becomes increasingly frequent. She gets a fever. At 11 o’clock (when all the Af…

A controversial 1998 study published in The Lancet implied that the MMR vaccine might be a cause of autism. This sparked deep suspicion of the vaccine and prompted a great deal of new research involving hundreds of thousands of children (that has been unable to find any such connection). The original study included only a dozen children, and was based partly on parents’ reports. In 2004, serious allegations were raised against this origin…

Children have received vaccines for many years. But in 1991, for the first time, newborns began receiving a vaccine. Has this caused an increase in SIDS or in vaccine-related deaths? Since 1991 over 86 million doses of the Hepatitis B vaccine have been given in the United States. An article in the December 1999 Archives of Pediatrics looked at the stories of the 18 children who had unexplained deaths within a month of having received the vacci…

Dr. Greene’s Answer: When deciding upon any immunization, it is wise to consider both the risks versus benefits of the vaccine and the risks versus benefits of not receiving the vaccine. Children who do not get the vaccine are likely to develop chickenpox. This common viral infection is usually mild and not life-threatening. Although these children may be miserable for several days, and miss a week of school or day-care (stranding parents…